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In one of the pandemic’s most puzzling and disturbing developments, scientists rush to explain what’s going on in Manaus, Brazil, a city of 2.2 million people on the edge of the rainforest of the country experiencing a second explosive epidemic, even though the first was so severe it was thought to have produced herd immunity.
As the situation worsens in Manaus, again overwhelming the city’s healthcare system, researchers in Brazil and the UK said yesterday that four possibilities could explain the recent dramatic resurgence, including the SARS virus variant. -CoV-2 that appeared in Brazil. They published their analysis yesterday in The Lancet.
The city’s epidemic last spring stunned the world with images of dead bodies on the streets, people buried in cardboard coffins and mass graves in local cemeteries. Seroprevalence studies over the summer estimated that 76% of Manaus residents had been infected, above the baseline herd immunity threshold of 67%.
However, a new surge that began in December has once again taken over the healthcare system, prompting other countries to help by sending in supplies of oxygen.
Doctors on the front lines say the second outbreak overwhelmed hospitals much faster than the first outbreak and patients are arriving at hospitals sicker, leading some to suspect that a new variant is circulating that isn’t just more transmissible, but also more deadly. , according to Washington post. Noaldo Lucena, MD, an infectious disease specialist at tropical medicine doctor Heitor Vieira Dourado in Manaus, told Publish. “It’s not a feeling. It’s a fact.”
A false sense of security, with some government officials downplaying the threat, entering the Christmas vacation may also have caught Manaus off guard as illnesses started to rise again in December, according to the Publish.
in the Lancet report, experts said that four factors may be at play, some possibly related. First, the scientists may have overestimated the attack rate for the first outbreak, and the infections could have been below the herd’s threshold of immunity. Second, the immunity of those infected in the first wave may have waned in December, which they say would not fully explain the resurgence.
Another factor could be the circulation of variants of SARS-CoV-2, some of which originate from Brazil, which elude the immune response from a previous infection with the original virus. And as a fourth possibility, the variants circulating in the second wave might be more transmissible than the virus that fueled the first wave.
The authors made reference to the discovery of the P.1 variant in Manaus, which began to appear in December with frequent detections. Although little is known about the variant, it shares mutations with variants from the UK and South Africa that may make it more heritable.
PAHO suggests P.1 is fueling Manaus surge
The latest epidemiological update from the Pan American Health Organization (PAHO) contained more details on local transmission of P.1 in Manaus, which appears to be based on an analysis of sequencing data by a team based at the Center for Arbovirus Discovery, Diagnostics, Genomics, and Epidemiology (CADDE) Genomic Network and published Jan. 12 on Virological.org.
The researchers wrote that the P.1 variant was not even detected in Manaus until November and that in December it made up 52.2% of the genotyped samples. In January, the proportion jumped to 85.4%. They also saw an increase in the P.2 variant in December, which was 25.4% but has since fallen to 6% in January.
Emphasizing that the results are preliminary, the group said that P.1 appears to be the driving force behind local transmission in Manaus, although P.2 and other bloodlines may still circulate.
PAHO today said in a statement on the variants circulating in the Americas that mutations are expected, underscoring its advice to countries to continue to strengthen their COVID-19 measures and surveillance for the virus.
Regarding the variant circulating in Manaus and the wider Amazon region, Sylvain Aldighieri, MD, the group’s incident manager, the researchers suggested a causal link with the increase in hospitalizations in Manaus, “But it is still early for conclude on the strength of the association between the emergence of the variant and the recent dynamics of transmission. “
Vietnam reports new outbreaks
In its first local cases in nearly 2 months and in its largest total in one day, Vietnam yesterday reported 84 new cases in two northern provinces, Hai Duong and Quang Ninh, according to Reuters. State media said cases were also detected in Bac Ninh province and Hai Phong, a port city.
Vietnam is among the countries that have received praise for keeping its COVID-19 cases and deaths at very low levels.
The developments have sparked a wave of urgent response measures, including mass testing in affected areas, halting international flights and banning gatherings before the Lunar New Year.
The government said some of the cases could be linked to the B117 variant which was first detected in the UK, according to the New York Times.
Ebbing European cases, WHO mission in China
In other international titles:
- Thirty European countries, some on lockdown, have reported a drop in COVID-19 cases over the past 2 weeks, but several schools, hospitals and nursing homes have reported outbreaks involving the variant virus, Hans Henri Kluge, MD, MPH, who heads the European regional office for the World Health Organization (WHO) said today. He said the region faces a “pandemic paradox”, with vaccines offering new hope, but variants posing a serious threat.
- Portugal today extended its national lockdown and announced foreign travel bans as hospitals are overwhelmed, according to Reuters. The country currently has the world’s highest 7-day per capita averages for cases and deaths, and Germany has sent medics to help.
- The WHO joint mission to China to investigate the animal source of SARS-CoV-2 has ended its 2-week quarantine in Wuhan and will begin operations in person, according to Reuters.
- The world has now passed 101 million and now has 101,253,267 cases with 2,184,718 deaths, according to the Johns Hopkins online dashboard.
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